Can Cognitive Decline Be Reversed Without an Environmental Lens?

For the past 11 years, I’ve hosted a monthly show called The Functional Forum, where we bring together the latest insights in functional and precision medicine. One of my most recent wrap-ups came from the American Academy of Environmental Medicine Conference in San Antonio, Texas, where TruNeura founder Dr. Kristine Burke was asked a crucial question:

"Is cognitive decline reversible without an environmental lens?"

If you fast forward to 44 minutes into the video, you can hear her answer for yourself. But the short version? No, it isn’t.

If we truly want to reverse cognitive decline and maintain success, we need to think bigger than just diet, exercise, connection and rest. We need an environmental lens—a structured way to assess, track, and mitigate the range of toxic burdens on the brain.

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The Environmental Factors Driving Cognitive Decline

Most doctors who specialize in cognitive health recognize the importance of metabolic inflammation, nutrient status, hormones, and vascular health. But without addressing environmental toxins, we’re missing a massive piece of the puzzle.

Environmental medicine teaches us that the modern world is saturated with neurotoxic substances—plastics, pesticides, air pollutants, heavy metals, mold toxins, and industrial chemicals—many of which have been directly linked to neurodegenerative diseases like Alzheimer’s.

Furthermore, we know the incredible cost of stress to the brain, and that can come in many forms. Psychosocial stress like loneliness seems to play a critical role, with significantly higher rates of cognitive decline in the lonely.

If we don’t identify, remove or support these exposures, how can we expect the brain to recover?

This is why TruNeura integrates the environmental lens directly into its core framework—ensuring that both patients and practitioners have a structured way to track and reduce toxic burden.

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How TruNeura Helps Track & Reverse Environmental Toxicity

At TruNeura, we break down the environmental lens into two essential areas:

1. What the Patient Can Control: The Pillars of Health

Patients need simple, actionable ways to reduce their toxic burden every day. Two of TruNeura’s core health pillars address this directly:

• REMOVE – What actions can you take (and can be prescribed by practitioners and coaches inside the software) to avoid and eliminate common toxins?

  • Filter your water to eliminate heavy metals and microplastics.

  • Switch to organic produce to reduce pesticide exposure.

  • Avoid plastic containers and processed foods that contain endocrine disruptors.

  • Use HEPA air filters to reduce indoor airborne pollutants.

• COMPOSE – How do you create an internal environment that supports a healthy function including detoxification?

  • Support gut health with targeted nutrition, fermented goods and fiber to enhance our primary detox pathways

  • Recommend probiotics

  • Remove common toxins from your environment

These simple but powerful interventions ensure that patients are actively participating in creating a brain-friendly environment. But what about the practitioner’s role in assessing deeper environmental burdens?

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2. What the Doctor Must Assess: The Root Cause Framework

In TruNeura’s six-subset root cause model, two key categories give practitioners the ability to precisely identify environmental triggers using specialty lab testing:

• Chemical Toxins – Identifies exposure to heavy metals (mercury, lead, aluminum), industrial chemicals (glyphosate, dioxins), and endocrine disruptors (BPA, phthalates).

• Biome and Biotoxins – Detects mold toxicity (mycotoxins), Lyme disease co-infections, and other biologically derived toxins that wreak havoc on the brain.

This data allows practitioners to go beyond guesswork—tracking exactly how environmental stressors are affecting cognitive function and tailoring detox protocols accordingly.

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Why the Environmental Lens is Non-Negotiable

Let’s be clear: without addressing environmental toxicity, any attempt to reverse cognitive decline will be at best short-lived. Dr Dean Ornish has showed the power of lifestyle medicine, but to sustain those gains, we have to deal with environmental causes.

We could give patients the best diet, supplements, and brain-training exercises in the world, but if they’re living in a mold-infested home, drinking pesticide-laced water, or accumulating heavy metals, their brain function will still deteriorate. Ask my father!

The problem is most neurologists and geriatricians never even ask these questions. They assume cognitive decline is inevitable—or at best, something to be "managed" with pharmaceuticals.

We are changing by empowering any clinic to deliver brain-first functional medicine.

By integrating environmental toxicity tracking directly into both patient-facing tools and clinical decision-making, we are ensuring that no potential driver of cognitive decline goes unchecked.

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The Future of Cognitive Health Starts Here

For too long, functional and precision medicine practitioners have lacked a unified system to address the complex, multi-layered nature of cognitive decline. We’ve known that environmental toxicity is a major player, but until now, tracking it effectively—and integrating it seamlessly into patient care—has been challenging.

With TruNeura, we’re closing that gap.

• For Patients – We provide simple, actionable strategies to reduce environmental exposures and optimize brain health daily.

• For Clinicians – We offer structured lab tracking and decision-making tools that prioritize environmental detoxification as a core component of cognitive health.

If you’re a practitioner looking to elevate your approach to cognitive health we’d love to connect.

Because when it comes to brain health, removing what’s harming the brain is just as important as providing what heals it.

Are you ready to lead the next evolution of cognitive care?

Let’s do it—together.